Nursing Elites

1. A new nurse has been assigned a client who is in the hospital to receive iodine-131 treatment. Which action by the nurse is best?

• A. Ensure the client is placed in protective isolation.
• B. Have pregnant visitors stay 6 feet from the client.
• C. No special action is necessary to care for this client.
• D. Read the policy on handling radioactive excreta.

Correct answer: D

Rationale: Handling radioactive excreta requires special precautions; the nurse must be familiar with the facility's policies.

2. In an adult patient, which assessment finding is considered diagnostic of Hodgkin lymphoma?

• A. Schwann cells
• B. Reed-Sternberg cells
• C. Lewy bodies
• D. Loops of Henle

Correct answer: B

Rationale: The correct answer is B: Reed-Sternberg cells. In Hodgkin lymphoma, the presence of Reed-Sternberg cells in lymph node biopsy is diagnostic. These cells are large, atypical cells originating from B-lymphocytes. They are distinctive in appearance and are key to diagnosing Hodgkin lymphoma. Choices A, C, and D are incorrect because Schwann cells are related to nerve function, Lewy bodies are associated with Parkinson's disease, and Loops of Henle are structures in the kidney, none of which are specific to Hodgkin lymphoma.

3. The nurse is instructing a client to perform a testicular self-examination (TSE). What information should the nurse provide about the procedure?

• A. To examine the testicles while lying down
• B. That the best time for the examination is after a shower
• C. To gently feel the testicle with one finger to feel for a growth
• D. That testicular self-examinations should be done at least every 6 months

Correct answer: B

Rationale: The correct answer is B. The best time to perform a testicular self-examination is after a warm shower when the scrotal skin is relaxed. This makes it easier to detect any abnormalities. Choice A is incorrect because the examination should ideally be done while standing. Choice C is incorrect as the client should use both hands to roll each testicle between the thumb and fingers to feel for any lumps or changes in size. Choice D is incorrect because testicular self-examinations are recommended to be done monthly, not every 6 months, to monitor changes in the testicles.

4. A client has been prescribed epoetin alfa for anemia related to chemotherapy. What lab value should the nurse monitor to determine the effectiveness of this medication?

• A. Hemoglobin level.
• B. Hematocrit level.
• C. White blood cell count.
• D. Platelet count.

Correct answer: A

Rationale: Epoetin alfa is a medication used to treat anemia, particularly anemia related to chemotherapy or chronic kidney disease. It stimulates the bone marrow to produce more red blood cells, which increases the hemoglobin level. Monitoring hemoglobin is the best way to assess the effectiveness of epoetin alfa, as an increase in hemoglobin indicates that the body is producing more red blood cells and the anemia is improving.

5. The nurse is caring for a client with multiple myeloma and is monitoring the client for signs of hypercalcemia. Which symptom would be an early indication?

• A. Polyuria
• B. Polyphagia
• C. Polydipsia
• D. Weight loss

Correct answer: A

Rationale: In patients with multiple myeloma, hypercalcemia is a common complication due to the release of calcium from the bones as a result of osteolytic lesions. One of the early symptoms of hypercalcemia is polyuria, or increased urine output. This occurs because elevated calcium levels can lead to impaired renal function and increased renal excretion of calcium, which results in increased urine production. Early recognition of polyuria can help prompt further evaluation and management of hypercalcemia, as untreated hypercalcemia can lead to more severe complications.

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